CT abdomen and pelvis with contrast at Inova Fairfax Hospital. CPT 74177.
What Inova Fairfax Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,065cash price (self-pay)
$2,129list price
$357–$3,787range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| aetna | medicare advantage | $357 |
| anthem | medicare advantage | $357 |
| united | medicare advantage | $357 |
| sentara health | medicare advantage | $364 |
| cigna | medicare advantage | $371 |
| kaiser | medicare advantage | $371 |
| humana | medicare advantage | $393 |
| anthem | medicaid advantage | $462 |
| united | medicaid advantage | $471 |
| sentara health | medicaid advantage | $476 |
| humana | medicaid advantage | $480 |
| aetna | medicaid advantage | $485 |
| kaiser | medicaid advantage | $508 |
| united | nonoptions | $846 |
| united | options | $846 |
| united | exchange | $846 |
| anthem | exchange hmo | $847 |
| anthem | hmo | $976 |
| anthem | ppo | $976 |
| sentara health | exchange | $1,044 |
| sentara health | hmo | $1,374 |
| sentara health | ppo | $1,374 |
| innovation | fully insured | $1,432 |
| aetna | fannie-mae | $1,487 |
| kaiser | hmo | $1,661 |
| kaiser | ppo | $1,661 |
| innovation | self insured | $1,724 |
| aetna | hmo | $1,739 |
| aetna | ppo | $1,739 |
| cigna | hmo | $3,374 |
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